| FAR、UHR在老年2型糖尿病肾病患者中的变化及早期诊断价值 |
| 投稿时间：2025-01-14 修订日期：2025-02-07 点此下载全文 |
| 引用本文：朱晨希,江颖飞,周玮逸,郝敬波,李雷.FAR、UHR在老年2型糖尿病肾病患者中的变化及早期诊断价值[J].医学研究杂志,2025,54(7):72-76 |
| DOI：
10.11969/j.issn.1673-548X.2025.07.014 |
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| 基金项目:江苏省老年健康科研项目(LK2021015)；徐州市科技项目(KC21268) |
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| 中文摘要:目的 探讨老年2型糖尿病肾病(diabetic kidney disease,DKD)患者中纤维蛋白原/白蛋白比值(fibrinogen to albumin ratio,FAR)、尿酸/高密度胆固醇比值(uric acid/high-density lipoprotein cholesterol ratio,UHR)的变化,以及上述指标对早期DKD的诊断价值。方法 选择老年2型糖尿病(type 2diabetes mellitus,T2DM)患者310例作为研究对象,根据尿微量白蛋白/尿肌酐比值(urine albumi to creatinine ratio,UACR)将其分为单纯T2DM组106例、早期DKD组121例和临床DKD组83例,比较3组的一般资料及实验室检查结果。结果 随着蛋白尿增加,FAR、UHR升高,早期DKD组及临床DKD组FAR、UHR均高于单纯T2DM组,临床DKD组FAR高于早期DKD组,差异均有统计学意义(P<0.05)。Spearman相关分析结果显示,UHR、FAR均与UACR(r=0.174,P=0.002；r=0.445,P＜0.001)、尿酸(uric acid,UA)(r=0.783,P<0.001；r=0.147,P=0.010)、肌酐(creatinine,Cr)(r=0.392,P＜0.001；r=0.332,P＜0.001)呈正相关,与eGFR(r=-0.114,P=0.045；r=-0.374,P<0.001)呈负相关。此外,UHR还与FAR(r=0.147,P=0.010)呈正相关。多因素Logistic回归分析结果显示,病程长、糖化血红蛋白水平高、收缩压高、FAR高、UHR高是发生DKD的危险因素(P<0.05),其中病程长、FAR高、UHR高是发生早期DKD的危险因素(P<0.05)。受试者工作特征(receiver operator characteristic, ROC)曲线分析结果提示,FAR、UHR联合病程对早期DKD有重要的诊断价值(AUC=0.803,95% CI:0.752～0.853)。结论 FAR及UHR升高与DKD的发生、发展密切相关,可能是发生早期DKD的独立危险因素,监测FAR、UHR并联合尿微量白蛋白检测有利于DKD的早期诊断。 |
| 中文关键词:2型糖尿病 老年 糖尿病肾病 纤维蛋白原/白蛋白比值 尿酸/高密度胆固醇比值 |
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| Changes of FAR and UHR in Elderly Patients with Type 2 Diabetic Kidney Disease and the Value of Early Diagnosis. |
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| Abstract:Objective To investigate the changes of fibrinogen/albumin ratio (FAR) and uric acid/high-density cholesterol ratio (UHR) in elderly patients with type 2diabetic kidney disease(DKD),as well as the value of the above indexes for early diagnosis of DKD. Methods 310 elderly type 2diabetes mellitus (T2DM) patients were selected and divided into 106 cases in the simple T2DM group, 121 cases in the early DKD group and 83 cases in the clinical DKD group according to the urinary microalbumin/urine creatinine ratio(UACR),and the general data and laboratory data of the three groups were compared. Results With the increase of proteinuria, FAR and UHR were significantly elevated,and FAR and UHR were higher in the early DKD group and clinical DKD group than in the simple T2DM group, and FAR was higher in the clinical DKD group than in the early DKD group, and the differences were statistically significant(P<0.05). Spearman′s correlation analysis showed that both UHR and FAR were positively correlated with UACR(r=0.174, P=0.002; r=0.445, P<0.001), UA(r=0.783, P<0.001; r=0.147,P=0.010), Cr(r=0.392, P<0.001; r=0.332,P＜0.001), and negatively correlated with eGFR(r=-0.114, P=0.045; r=-0.374, P<0.001).In addition, UHR was positively correlated with FAR(r=0.147, P=0.010). The results of multiple Logistic regression analysis showed that long disease course, high glycated hemoglobin level, high systolic blood pressure, high FAR, and high UHR were risk factors for the occurrence of DKD(P<0.05); among which long disease course, high FAR, and high UHR were risk factors for the occurrence of early DKD(P<0.05). ROC curve analysis suggested that FAR and UHR combined with disease duration had an important diagnostic value for the occurrence of early DKD(AUC=0.803,95% CI:0.752-0.853). Conclusion Elevated FAR and UHR are closely related to the development of DKD and may be independent risk factors for the occurrence of early DKD. Monitoring FAR and UHR in combination with urine microalbumin testing is benefical for the early diagnosis of DKD. |
| keywords:Type 2diabetes mellitus Elderly Diabetic kidney disease Fibrinogen to albumin ratio Uric acid/high-density lipoprotein cholesterol ratio |
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